| NPI | 1700556776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209025510) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28268295A) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IN 28268295A) | |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2026-02-05 |